Leadership, Collaboration, Communication, Change Management, and Policy Considerations

In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Please see attachment

Answer

Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Improving patient outcomes is a product of various professional nursing strategies. To achieve these outcomes, the agents of change – the nurses – plan and execute the best interventional strategies. Professional nurses identify health problems, assess the problem, plan the interventions to address these problems, and strategize implementation, among other concepts. The purpose of this paper is to identify a health problem and explain how nursing leadership, communication, nursing collaboration, change management, and state and federal policies would affect this health problem.

Definition of Problem

Obesity and overweight have been health problems worldwide. There has been an exponential increase in rates of obesity and overweight worldwide among younger populations (Kinlen et al., 2018). It has become a global health concern among children and adolescents, thus raising awareness about preventive health (Suh & Kim, 2019). Overweight and obesity place individuals at risk of various diseases, including but not limited to hyperlipidemia, diabetes mellitus, hypertension (Landsberg, 2018), gallstones, sleep apnea, osteoarthritis, and stroke. Mental health complications are also seen with obesity ad overweight (CDC, 2022). Depression and anxiety are the main mental illnesses associated with obesity.

Obesity, as a health problem, is complex and multifaceted. There is no simple solution to this health problem; thus, many healthcare professionals can play certain roles in achieving the prevention health promotion. This health problem requires concerted efforts from other fields of practice at the population level. Global health means local health too and without addressing the local health, the problem becomes a global health concern. At an individual and local level, various actions can be taken to prevent obesity and its related complication.

Patient Problem

My patient in this capstone project is called Angie. Angie is a 25-year-old white female who is also a friend. She is the second born in a family of 2 with both parents alive. The father just suffered acute myocardial infarction 3 months ago. The mother had cholecystectomy for symptomatic gallstones five years ago. Two of her maternal uncles are diabetic, and one is hypertensive. Angie just graduated with a bachelor’s degree from the university and hopes to land a job soon. She also hopes to start her family with her fiancé after landing a job. However, she has been worried over information that she got from the internet that suggested she may be infertile. Her last measured weight was 196 pounds, and she is 5”3 tall. Her body mass index (BMI) is 34.7 kg/m2. Objectively, Angie has obesity, class I. She fears that she may get complications that arise from her obesity. Her health problem has not caused her any illnesses so far. On some occasions, she has faced discrimination over her weight – both verbal and behavioral.

Angie’s weight has been a problem for her because she has tried weight-loss interventions but sometimes ends up eating twice the daily number of calories after physical exercises and a period of dieting. Her weight has been rising despite these interventions. From our last discussion with her, she had no evidence of significant depression or anxiety. Her subjective description of her mood and affect were normal, and there were no sleep problems. Her main concern was the positive family history of health complications that had been associated with obesity. Having read on the internet, she fears that she may get obesity, diabetes, and heart diseases in the future. Her current weight and evidence from the literature can substantiate these health problems. Having verbally consented to be included in my capstone project, I intend to work with Angie. Her health problem is relevant to my future practice as a baccalaureate-prepared nurse. She requires preventive, promotive, and curative care that will require a multidisciplinary approach, and as a nurse, my input is relevant in ensuring leadership, collaboration, change management, and communication.

Evidence from Literature

Obesity is no longer a disease of adults or a specific race but a global health concern. Individuals with obesity experience psychological, physical, social, and economic issues. According to Moini et al. (2020), obesity has many complications in various body organ systems. These complications are associated with a shorter lifespan and reduced quality of life. Psychosocial problems are related to poor body image, dissemination, low self-esteem, and other people handling these individuals with prejudice. Obese individuals have at once attempted to reduce their weight on their own through dieting and increasing physical activity. Not always do these self-interventions lead to successful outcomes. Sometimes, a phenomenon called weight cycling occurs where these individuals will regain weight after losing.

Angie most likely has weight cycling and is suffering the psychological consequences of obesity. Weight cycling affects the cardiovascular system as well as other organ systems (Moini et al., 2020). Physiological stress and increased cardiovascular disease risks are some of the effects of rapid weight-loss strategies and weight cycling (Artioli et al., 2019). Paradoxically, obesity increases cardiovascular disease risk, while aggressive strategies to treat obesity, such as rapid weight loss, also increase cardiovascular disease risks. Therefore, the plan for weight management requires an evidence-based basis.

Obesity is one of the most known and studied complications of obesity. Recent trends have reported type 2 diabetes among the youthful population. According to Artioli et al. (2019), insulin resistance is responsible for the development of diabetes mellitus type II. In children and adolescents, diabetes mellitus type 2 has been observed and reported in metabolic syndromes. Severe obesity and associated dyslipidemia are also significant complications that affect the young and obese population. Among females, infertility arises from polycystic ovarian syndrome, which is characterized by obesity. Therefore, Angie’s fear is evidence-based, and she needs preventive care.

Obesity care is influenced by attuites of caregivers, social perceptions, and those of healthcare professionals. In a study by Darling & Atav (2019), perceptions and attitudes varied between nurses and social workers, influencing the care that their obese patients receive. Depression and anxiety become a menace to these individuals as their obesity progresses. These psychological changes are associated with the social environment and genetic predisposition (Fulton et al., 2022). These items of literature used in substantiating the significance of Angie’s health problem show that obesity is, indeed, a multifaceted problem. They reflect every detail that is seen in obese and overweight. I have observed self-esteem issues and sometimes mood problems in these individuals. Most diabetic or hypertensive adults that I observe design my training are physically heavy and overweight.

Role of Health Policies and Regulations

Federal and state-based policies have been in place to prevent obesity. The government has approached the matter through legislation and health programs. State boards of nursing have implemented these policies at school, in the community, and within health institutions. An example of such policies is the city taxation on unhealthy foods, including sugar. Increment in taxations on sugar aims at reducing its consumption and reducing obesity among consumers. Health laws and programs such as provision by the Child and Adult Care Food Program (CACFP) and US Department of Agriculture (USDA) food policies have been in place to prevent obesity. Nurses, especially community health nurses, should be conversant with these policies and programs when effectuating their interventions at the community health level. The state boards of nursing implement national policies and programs at the state level, thus it is within the nurse’s scope to adhere to state obesity policies and implement these policies in their practice. As a nurse, I will be obliged to participate in policy implementation as well as policy-making as part of the scope of practice in the care of my patient.

Proposed Leadership Strategies

A multidisciplinary approach would confer the best results in the care for Angie. As such, a good team leader will be required for successful patient outcomes. As a clinical nurse leader in this team, leadership strategies for the nurse include care coordination, communication, and collaboration. As a leader, the nurse can first discuss the best management strategies with the patient. This will also include assisting the patient in goal setting and providing the best intervention to achieve these goals. The leader should also connect the patient to the best care professionals that would provide appropriate professional care to achieve the patient’s goals. The final leadership strategy is to coordinate the care for the patient. Therefore, communication and collaboration skills will be required to coordinate Angie’s care for the best outcomes.

Managing the perception and attitude of the care team is also a critical leadership strategy. According to Hitch et al. (2020), efforts to manage obesity inpatients should focus on managing the attitudes and perceptions of those around the patient. Being aware of the risks of obesity and the impact of stigma, discrimination, and stereotyping of obese patients is an essential aspect of clinical nurse leadership (Darling & Atav, 2019). Nursing leadership is, therefore, critical in Angie’s care.

Conclusion

This capstone project is about an actual friend called Angie (not her real name) who has obesity with a BMI of 34.7. She has a positive family history of cardiovascular diseases that are usually associated with obesity. She is 25 years old, and she is worried that she may get thee complications in the future. She has tried personal interventions to manage her weight, but she gets weight cycling. She is most concerned about infertility that she read over the internet. Her health problems include the psychological consequences of obesity and the need for preventive health. Evidence from the literature supports the existence of her health problem and the clinical impact of the clinical condition. Therefore, there is to initiate and plan her care to achieve the best outcomes and prevent obesity complications. Her care requires a multidisciplinary approach, and the nurse has a central role in her care. Nursing leadership strategies such as care coordination, communication, and policy implementation. State board of nursing regulations and standards will also impact the role of the nurse in this team as well as the scope of practice.

References

Artioli, G. G., Solis, M. Y., Tritto, A. C., & Franchini, E. (2019). Nutrition in Combat Sports. In Nutrition and Enhanced Sports Performance (pp. 109–122). Elsevier. https://doi.org/10.1016/b978-0-12-813922-6.00009-6

CDC. (2022, May 13). Health effects of overweight and obesity. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/effects/index.html

Darling, R., & Atav, A. S. (2019). Attitudes toward obese people: A comparative study of nursing, education, and social work students. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing35(2), 138–146. https://doi.org/10.1016/j.profnurs.2018.07.009

Fulton, S., Décarie-Spain, L., Fioramonti, X., Guiard, B., & Nakajima, S. (2022). The menace of obesity to depression and anxiety prevalence. Trends in Endocrinology and Metabolism: TEM33(1), 18–35. https://doi.org/10.1016/j.tem.2021.10.005

Hitch, D., Pazsa, F., & Qvist, A. (2020). Clinical leadership and management perceptions of inpatients with obesity: An interpretative phenomenological analysis. International Journal of Environmental Research and Public Health17(21), 8123. https://doi.org/10.3390/ijerph17218123

Kinlen, D., Cody, D., & O’Shea, D. (2018). Complications of obesity. QJM: Monthly Journal of the Association of Physicians111(7), 437–443. https://doi.org/10.1093/qjmed/hcx152

Landsberg, L. (2018). Obesity. In Hypertension: A Companion to Braunwald’s Heart Disease (pp. 328–334). Elsevier. https://doi.org/10.1016/b978-0-323-42973-3.00035-4

Moini, J., Ahangari, R., Miller, C., & Samsam, M. (2020). Global health complications of obesity. Elsevier Science Publishing. https://doi.org/10.1016/c2018-0-03363-0

Santoro, N., Giannini, C., & Caprio, S. (2018). Obesity and type 2 diabetes in youths. In Nutritional and Therapeutic Interventions for Diabetes and Metabolic Syndrome (pp. 43–52). Elsevier. https://doi.org/10.1016/b978-0-12-812019-4.00004-0

Suh, S.-H., & Kim, Y.-S. (2019). Childhood obesity: Exercise physiologists’ perspective. In Global Perspectives on Childhood Obesity (pp. 59–78). Elsevier.

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